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Systematic Review Article

Benzodiazepines and Sleep Architecture: A Systematic Review

Author(s): Felipe Maraucci Ribeiro de Mendonça, Giulia Paulo Rossi Ribeiro de Mendonça, Laura Costa Souza, Lucas Pequeno Galvão, Henrique Soares Paiva, Cintia de Azevedo Marques Périco, Julio Torales, Antonio Ventriglio, João Maurício Castaldelli-Maia and Anderson Sousa Martins Silva*

Volume 22, Issue 2, 2023

Published on: 26 November, 2021

Page: [172 - 179] Pages: 8

DOI: 10.2174/1871527320666210618103344

open access plus

Abstract

Background: Insomnia, defined as a difficulty in initiating or maintaining sleep, is a relevant medical issue. Benzodiazepines (BZDs) are commonly prescribed to treat insomnia. Two phases characterize human sleep structure: sleep with Non-Rapid Eye Movement (NREM) and sleep with Rapid Eye Movement (REM). Physiological sleep includes NREM and REM phases in a continuous cycle known as “Sleep Architecture.”

Objective: This systematic review summarizes the studies that have investigated effects of BZDs on Sleep Architecture.

Methods: The articles selection included human clinical trials (in English, Portuguese, or Spanish) only, specifically focused on BZDs effects on sleep architecture. PubMed, BVS, and Google Scholar databases were searched.

Results: Findings on BZDs effects on sleep architecture confirm an increase in stage 2 of NREM sleep and a decrease in time of stages 3 and 4 of NREM sleep with a reduction in time of REM sleep during the nocturnal sleep.

Conclusion: Variations in NREM and REM sleep may lead to deficits in concentration and working memory and weight gain. The increase in stage 2 of NREM sleep may lead to a subjective improvement of sleep quality with no awakenings. BZDz should be prescribed with zeal and professional judgment. These patients should be closely monitored for possible long-term side effects.

Keywords: Benzodiazepines, sleep, sleep architecture, sleep slow-wave, sleep REM, sleep stages.

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